Asystole in ECT

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Letter to the Editor

Sir: In an excellent discussion of asystole in electroconvulsive therapy, Dr. McCall makes a number of useful suggestions to minimize the likelihood that asystole will occur. I would like to amplify his treatment recommendation of intravenous atropine injection. Without cardiac function during asystole, atropine administered through a peripheral vein will not reach the heart unless “pushed” by a 20- to 30-mL fluid bolus followed by elevation of the arm.

J Clin Psychiatry 1997;58(12):550 [letter]